Whatever you call them, 'e-cigarettes' improve public health

Article by: Charles D. Connor

McClatchy-Tribune News Service

October 24, 2013 - 11:45 AM

At times over the past century, certain revolutionary technological advancements have resulted in new consumer goods that disrupted the product landscape so quickly and significantly, that our language struggled to catch up. The term ‘mechanized horse’ was used frequently in the early days to describe the automobile, and the term ‘smartphone’ is still widely accepted and used but seems antiquated and inaccurate given the large list of functions we perform on these devices.

More often than not, misnomers like this are harmless. But sometimes improper labels can become more than just a matter of semantics - they can affect public policy and national health.

This is currently the fate of the “electronic cigarette.” Despite the product’s name, it is not a cigarette at all. Unlike “traditional” cigarettes, their electronic “counterparts” do not contain tobacco leaves meant for combustion. Rather, they are simply nicotine delivery devices. While e-cigarettes are not currently sold, marketed or regulated as smoking cessation products, they are used mostly by people who are desperate for an alternative to smoking tobacco cigarettes.

The public health community has long recognized that the real danger from a tobacco cigarette is the result of combusting tobacco and inhaling it into the smoker’s lungs. However, the user is typically not seeking the satisfaction and pleasure of filling his/her lungs with smoke. Rather, it is the nicotine in each cigarette that they are after - an ingredient that, while addictive, in small dosages is itself no more harmful than a cup of coffee.

Given the deadly consequences of cigarette smoking, the passion of health policy advocates and legislators for eliminating tobacco use from society is understandable and commendable. Regrettably, however, these same good folks are mistaken when they fail to acknowledge the obvious differences between “traditional” tobacco cigarettes and electronic cigarettes.

Yes, of course we need long-term health studies of electronic cigarettes. But this is a new product and, by definition, “long-term” studies will take a “long” time. Those could be precious years for current cigarette smokers who may be desperately seeking an alternative nicotine delivery device.

A typical tobacco cigarette is actually a highly engineered product, containing hundreds of chemicals - many of them carcinogenic - that are not disclosed to the consumer. The good news is that we have a fairly reliable understanding of the contents of an electronic cigarette and the vapor it produces. We know that propylene glycol, a main ingredient, is found in many foods we eat, where it is commonly used as a preservative.

We also know that electronic cigarettes don’t have the same smell, irritation or secondhand smoke that comes from traditional tobacco cigarettes.

If there is a different method of consuming nicotine than combusting tobacco -the most deadly part of a cigarette by far - why aren’t we doing all we can to encourage people to switch? Reducing harm to smokers by moving them down the continuum of risk is a recognized approach to successfully reducing risky behavior, especially in situations where addiction is an issue.

Electronic cigarettes should be regulated. The industry’s products should meet certain standards of quality, consistency and nicotine levels. Like many other chemicals/substances suitable for human consumption at certain dosages, nicotine can be extremely dangerous in higher concentrations. Furthermore, it is important that there be regulated efforts to eliminate youth access to the product, both in physical store locations and Internet sales.

While we need more science on electronic cigarettes, common sense should tell us that a product that does not combust tobacco should not be put on an equal regulatory footing with one that does.

We should recognize that these new vapor devices are no more “cigarettes” than a motor vehicle is a “mechanized horse.” Just as our automobiles aren’t subjected to the laws relating to the humane treatment of horses, neither should these new nicotine delivery devices be treated with the same broad brush stroke as tobacco cigarettes.

Charles D. Connor is a former president and CEO of the American Lung Association and is a consultant to the Electronic Cigarette Industry Group. The opinions are those of the writer and do not necessarily represent the views of McClatchy-Tribune or its editors.